Write 10 page essay on the topic Pain in unresponsive patients.A contributing factor for this could be that the various pain scales available for noncommunicative patients generally are subjective and

Write 10 page essay on the topic Pain in unresponsive patients.

A contributing factor for this could be that the various pain scales available for noncommunicative patients generally are subjective and, therefore, lacking in inter-rater reliability. Besides, research in pain assessment tools has not been adequate. The major aims of this study are (1) to compare the Numerical Rating Scale and the Behavioral Pain Scale for measuring pain in unresponsive patients, and

Pain is an important problem in critical care and accurate assessment of pain in the unresponsive patient is indeed a challenge. The unresponsive patients include pediatric, trauma, surgery, cancer, and critically ill, end-of- life cases. The attending nurses are generally accountable for pain management in the patient. It is estimated that critically ill patients dying in the ICU account for nearly 20% of the hospital deaths (Rocker & Curtis, 2003). Hence, nursing care decisions made at the end of life are crucial for the comfort of the patient. Palliative care has been defined by the World Health Organization as “the total care of patients and families whose disease is not responsive to curative treatment” (WHO, 1990, p.11). Assessment and management of pain in the palliative care is a very difficult process especially in the case of a non-verbal patient (Gambrell, 2005). Health-care providers play an active role in managing pain and providing comfort to such patients. But unmitigated pain in the absence of adequate use of analgesics and sedatives can lead to enhanced morbidity and mortality in patients in the ICU (Ahlers et al., 2008).

The tools available for pain assessment in noncommunicative patients are mostly subjective which is a great drawback. Ideally, an objective tool for quantification of pain intensity capable of providing a quick feedback would be needed to provide comfort to the unresponsive patient (Gambrell, 2005). Critically ill patients show a variety of hormonal changes and neurogenic blockade and analgesia with local anaesthetics can prevent